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Medicines for Cluster Headaches

Topic Overview

Medicines may stop a
cluster headache after it starts and prevent
more headaches from occurring. Finding the right medicine can take some
time. You may need a combination of medicines to effectively treat your cluster
headaches.

Medicines and treatments that stop cluster headaches after they start

Treatments most often used to stop cluster headaches
include:

High-flow oxygen inhalation therapy, in which you breathe oxygen through a face mask to relieve headache pain. Oxygen therapy is one of the best treatments to stop a cluster headache. Oxygen therapy relieves headache pain within 15 minutes in more than 7 out of 10 people who use it. It works best when started right when a cluster headache starts.1 But you need to repeat the treatment when
the next headache begins.

Triptans, which can be given as a shot, sprayed in the nose, or taken by mouth as a pill to
reduce pressure and pain.

Ergotamine preparations, which can be given as a pill or in a vein to relieve pressure and reduce headache pain.

Medicines that prevent cluster headaches during a cluster period

Medicines that prevent cluster headaches during a cluster
period include:

Corticosteroids, such as prednisone. These medicines
are used to stop cluster headaches for a short time. These medicines give you
some relief from headaches while preventive medicines start to work. Corticosteroids are not used as
preventive medicines long-term because of bad side effects.

Verapamil. This medicine is used to prevent or reduce
the number of headaches in a cluster cycle. Verapamil is
commonly used for preventing both occasional and chronic cluster headaches.

Lithium. This medicine is often prescribed to prevent chronic
cluster headaches.

Ergotamine. This medicine can be used at bedtime to prevent cluster headaches overnight.

You must take these
medicines every day during a cycle of headaches, even on days when you don't
get a headache.

What to think about

Over-the-counter pain medicines, such as aspirin, acetaminophen,
and ibuprofen, usually don't relieve the severe pain of cluster headaches.
Also, prescription narcotic pain medicines are not recommended for cluster
headaches.

When a
cluster headache occurs, it is important to treat it as early as possible with the
medicine your doctor has recommended. The sooner you treat the headache, the
less painful it may be.

The choice of medicine may depend on the
time of day when your headaches tend to occur. Some people may need a
combination of two or three medicines. Keeping track of your symptoms can help your
doctor determine the proper medicine. You can keep track by using a
headache diary(What is a PDF document?).

If you don't get headaches often, you may only need to
take medicines after the headaches begin. If you get headaches often, you
may need to take medicines daily during a cluster period to prevent a future
headache or reduce the number of headaches in a cycle.

If your headaches become more severe and medicines aren't
working, let your doctor know. You may need to try a different medicine or a
combination of medicines. You may also need to be referred to a hospital or
headache clinic for more intensive treatment.

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How this information was developed to help you make better health decisions.